不同浓度丙酮酸盐透析液用于失血性休克大鼠腹腔复苏效果的比较  

Comparison of different concentrations of pyruvate-based peritoneal dialysis solution for peritoneal resuscitation in a rat model of hemorrhagic shock

作　　者：沈会琴 颜学滔[2] 张婧婧[1] 邓江涛 熊颖 蒋琳琳[1] 张琼月[1] 吴唐静 金哲[1] 张宗泽[1] 王焱林[1] Shen Huiqin;Yan Xuetao;Zhang Jingjing;Deng Jiangtao;Xiong Ying;Jiang Linlin;Zhang Qiongyue;Wu Tangjing;Jin Zhe;Zhang Zongze;Wang Yanlin(Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China;Department of Anesthesiology, Shenzhen Baoan Maternal and Child Health Hospital, Shenzhen 518100, China)

机构地区：[1]武汉大学中南医院麻醉科,430071 [2]深圳市宝安区妇幼保健院麻醉科,518100

出　　处：《中华麻醉学杂志》2019年第1期101-104,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金(81601678).

摘　　要：目的比较不同浓度丙酮酸盐透析液用于失血性休克大鼠腹腔复苏的效果。方法SPF级健康雄性SD大鼠40只,体重200~250 g,采用随机数字表法分为4组(n=10):假休克组(S组)、常规静脉复苏组(VR组)和不同浓度丙酮酸盐透析液腹腔复苏组(PY1组和PY2组)。经左股动脉穿刺放血,维持MAP 30~40 mmHg,时间60 min,随后回输部分血液,以制备失血性休克模型。VR组于失血性休克l h后回输自体血及2倍失血量的生理盐水进行静脉复苏;PY1组和PY2组在常规静脉复苏同时,分别腹腔输注40与80mmol/L丙酮酸盐透析液20 ml,输注时间30 min。于放血前(T0)、休克5、30、60 min(T1-3)、复苏结束后5、30、60、90、120 min(T4-8)时记录MAP。T8时取动脉血样1 ml,行血气分析,记录pH值、PaO2、PaCO2、BE以及HCO3^-。结果与S组比较,VR组和PY1组T1-8时、PY2组T1-7时MAP降低,VR组pH值、PaO2、BE及HCO3-降低,PaCO2升高,PY1组和PY2组PaO2及HCO3-降低(P<0.05);与VR组比较,PY1组和PY2组T4-8时MAP升高,pH值、PaO2、BE及HCO3^-升高,PaCO2降低(P<0.05);与PY1组比较,PY2组T6-8时MAP升高,pH值升高(P<0.05),PaO2、PaCO2、BE及HCO3^-差异无统计学意义(P>0.05)。结论80 mmol/L丙酮酸盐透析液用于失血性休克大鼠腹腔复苏的效果优于40 mmol/L。Objective To compare the efficacy of different concentrations of pyruvate-based peritoneal dialysis solution for peritoneal resuscitation in a rat model of hemorrhagic shock. Methods Forty SPF healthy male Sprague-Dawley rats, weighing 200-250 g, were assigned to 4 groups (n=10 each) using a random number table method: sham operation group (S group), routine IV resuscitation group (VR group), and intraperitoneal resuscitation with different concentrations of pyruvate-based peritoneal dialysis solution groups (PY1 group, PY2 group). The animals were anesthetized with pentobarbital sodium 400 mg/kg.Hemorrhagic shock was induced by withdrawing blood from the left femoral artery until mean arterial pressure (MAP) was reduced to 30-40 mmHg and maintained for 60 min, and the animals were then resuscitated by infusion of shed blood.In VR group, hemorrhagic shock was resuscitated by retransfusion of autologous blood and with normal saline 2 times the volume of blood loss at 1 h after hemorrhagic shock.Routine IV resuscitation was performed, and 40 and 80 mmol/L peritoneal dialysis solution 20 ml were intraperitoneally infused for 30 min at the same time in PY1 and PY2 groups, respectively.MAP was recorded before blood-letting (T0), at 5, 30 and 60 min of shock (T1-3) and 5, 30, 60, 90 and 120 min after the end of resuscitation (T4-8). Blood samples were collected at T8 for blood gas analysis, and pH value, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), base excess (BE), and bicarbonate ion concentration (HCO3-) were recorded. Results Compared with S group, MAP was significantly decreased at T1-8 in VR and PY1 groups and at T1-7 in PY2 group, and pH value, PaO2, BE and HCO3^- were significantly decreased, and PaCO2 was increased in VR group (P<0.05). Compared with VR group, MAP at T4-8, pH value, PaO2, BE and HCO3^- were significantly increased, and PaCO2 was decreased in PY1 and PY2 groups (P<0.05). Compared with PY1 group, MAP at T6-8 and pH value were significantly increased (P<0.05), an

关 键 词：丙酮酸 腹膜透析 复苏术 休克 失血性 

分 类 号：R605.971[医药卫生—急诊医学]